The AccuNurse System has been successfully developed in Phase I to provide an easy-to-use "mentor" and communications tool for CNAs and nurses in skilled nursing units. Wireless and advanced speech technologies are merged into a conversational system that provides: individualized resident information, paperless documentation at the point of care, and many other features that improve quality of care. The system works as follows: A nurse enters the CNA care plans on a host computer, with simple screens that require mouse clicks. The CNAs and nurses then have wireless access to this information, in spoken form, by wearing a cordless telephone and headset. All they need to do is speak into the headset to (a) access care plan information, (b) report a completed activity, (c) record a clinical note, (d) record weight, vital signs and input/output at the point of care, and (d) locate and speak with another staff member. They also can listen to an incoming scheduled reminder from AccuNurse such as patient repositioning. The overall aim of the Phase 2 study is to establish the commercial viability of an enhanced AccuNurse system in skilled nursing units on all three shifts, 7 days a week. The system will be tested at two continuing care retirement communities for 12 months, by full-time, part-time, and temporary, staff. We plan to enhance the AccuNurse system based on the results of Phase 1, customize the messages to meet each facility's needs, and develop an interface with each facility's information system (including care plans and MDS). The Phase 2 project team includes all the Phase 1 participants plus Kendal Corporation, a leader in elder care with 8 continuing care retirement communities.